When your infant comes down with a cold, you need to be on the alert. Baby colds can quickly turn into acute bronchiolitis, a serious lower respiratory tract illness that causes swelling of the small airways in the lungs. The Respiratory Syncytial Virus (RSV) is the most common cause of acute bronchiolitis. While the infection can occur from birth to two years of age, infants between ages two and six months are the most susceptible.
How is RSV transmitted? Although RSV is a respiratory virus, it is transmitted mainly by direct hand contact from infected individuals.
What are the signs and symptoms? Typically, an affected infant has cold-like symptoms such as nasal congestion, runny nose, low-grade fever, decreased appetite and irritability. After several days, symptoms progress to rapid breathing, rapid heart rate and a hacking cough, suggesting the spread of the viral infection to the lower respiratory tract. Increasing respiratory distress may cause the skin around the mouth to turn a bluish color (cyanosis). Your infant may also produce a wheezing sound when breathing while the muscles between the ribs and below the rib cage retract. Your baby may appear very sleepy, and dehydration may result from reduced feedings.
How is it diagnosed? A test can be performed in the hospital to confirm the diagnosis of RSV bronchiolitis, but often a history and physical exam are sufficient to make the diagnosis. A chest x-ray may also be helpful.
Can it be confused with other diseases? Asthma is a major consideration in children with bronchiolitis and is the more likely diagnosis if there have been previous episodes of wheezing.
Gastric reflux with aspiration of the stomach contents may also produce the symptoms of bronchiolitis, but cold-like symptoms do not precede respiratory distress in these cases.
How is it treated? Most children are treated at home and improve within three to five days. Underlying conditions such as prematurity, heart disease, and a weakened immune system puts a child at high-risk for more serious complications from the disease. These babies should be monitored more closely.
